Projected Impact of Salt Restriction on Prevention of Cardiovascular Disease in China: A Modeling Study

• Published in: PloS one Vol. 11; no. 2; p. e0146820
• Main Authors: Wang, Miao, Moran, Andrew E, Liu, Jing, Coxson, Pamela G, Penko, Joanne, Goldman, Lee, Bibbins-Domingo, Kirsten, Zhao, Dong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.02.2016; Public Library of Science (PLoS)
• Subjects: Adult; Adults; Aged; Aged, 80 and over; Analysis; Blood Pressure; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; China - epidemiology; Cooking; Costs; Diet; Diet, Sodium-Restricted; Dietary intake; Dietary restrictions; Female; Health aspects; Health Care Costs; Health risk assessment; Humans; Hypertension; Male; Middle Aged; Models, Theoretical; Mortality; Nutrition; Prevalence; Prevention; Quality-Adjusted Life Years; Reduction; Risk; Salt (Food); Salts; Sodium chloride; Sodium Chloride, Dietary - administration & dosage; China; Beijing China; New York; San Francisco California; California; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0146820

To estimate the effects of achieving China's national goals for dietary salt (NaCl) reduction or implementing culturally-tailored dietary salt restriction strategies on cardiovascular disease (CVD) prevention. The CVD Policy Model was used to project blood pressure lowering and subsequent downstream prevented CVD that could be achieved by population-wide salt restriction in China. Outcomes were annual CVD events prevented, relative reductions in rates of CVD incidence and mortality, quality-adjusted life-years (QALYs) gained, and CVD treatment costs saved. Reducing mean dietary salt intake to 9.0 g/day gradually over 10 years could prevent approximately 197 000 incident annual CVD events [95% uncertainty interval (UI): 173 000-219 000], reduce annual CVD mortality by approximately 2.5% (2.2-2.8%), gain 303 000 annual QALYs (278 000-329 000), and save approximately 1.4 billion international dollars (Int$) in annual CVD costs (Int$; 1.2-1.6 billion). Reducing mean salt intake to 6.0 g/day could approximately double these benefits. Implementing cooking salt-restriction spoons could prevent 183 000 fewer incident CVD cases (153 000-215 000) and avoid Int$1.4 billion in CVD treatment costs annually (1.2-1.7 billion). Implementing a cooking salt substitute strategy could lead to approximately three times the health benefits of the salt-restriction spoon program. More than three-quarters of benefits from any dietary salt reduction strategy would be realized in hypertensive adults. China could derive substantial health gains from implementation of population-wide dietary salt reduction policies. Most health benefits from any dietary salt reduction program would be realized in adults with hypertension.